Reactions 845 - 31 Mar 2001

SCitalopram

Syndrome of inappropriate secretion of antidiuretichormone in an elderly patient: case report

A 78-year-old woman developed acute severehyponatraemia due to the syndrome of inappropriate secretionof antidiuretic hormone (SIADH) during treatment withcitalopram.

The woman was hospitalised with a 2-day history ofvomiting and progressive lethargy, and on examination, wasfound to be disorientated and confused. Six days beforeadmission she had started treatment with citalopram 10mg/day. Her other medications were thyroxine, pentoxifylline,amiloride, hydrochlorothiazide and warfarin all of which shehad taken for 3 years. Laboratory analysis showed thefollowing serum levels; sodium 113 mmol/L, potassium 5.1mmol/L, urea 22 mg/dl, and creatinine 1.3 mg/dl.

The woman was diagnosed with SIADH and citalopram wasdiscontinued. She was treated with water restriction, infusionof 3% sodium chloride and infusion of isotonic saline. Hercondition gradually improved and 4 days later her serumsodium level had increased to 130 mmol/L.

Author comment: ‘The present case and the otherpreviously reported cases of SIADH associated with citalopramtherapy emphasize the need for greater awareness of thedevelopment of this serious and potentially fatal complicationin association with citalopram therapy. Serum sodium levelsshould be monitored closely in elderly patients after they starttreatment with any SSRI agent, including citalopram,particularly in the first 4 weeks of therapy’.Odeh M, et al. Severe symptomatic hyponatremia during citalopram therapy.American Journal of the Medical Sciences 321: 159-160, No. 2, Feb 2001 -Israel 800830478

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Reactions 31 Mar 2001 No. 8450114-9954/10/0845-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved